Study to understand why YMSM place themselves at risk for HIV transmission

The number of new HIV infections in the United States had remained steady in recent years, but rates among urban millennial gay, bisexual, and other young men who have sex with men (YMSM) have steadily increased in the past decade.

New York University researchers, led by Perry Halkitis, a professor at the Steinhardt School of Culture, Education, and Human Development, the Global Institute of Public Health, and NYU Langone Medical Center, will study this population in order to better understand the reasons for this increase under a five-year, $3.1 million grant from the National Institute on Drug Abuse, part of the National Institutes of Health.

The research is a continuation of a study of young men that began in 2009 under the name Project 18 (P18).

"The goal of this project is to understand why a new generation of YMSM place themselves at risk for HIV transmission," explains Halkitis, who is also associate dean for academic affairs at NYU's Global Institute of Public Health. "We aim to understand why some men exhibit risky behaviors as they emerge into adulthood while others do not."

The project's other researchers include three faculty in NYU Steinhardt's Public Health program-Farzana Kapadia, the primary co-investigator, Danielle Ompad, and Rafael Perez Figueroa-as well as Richard Greene, an assistant professor at NYU Langone Medical Center.

YMSM include not only gay men, but also those who are bisexual and heterosexual men but who have had sex with other men but do not identify as gay or bisexual.

Under the grant, the research team will continue its cohort study of nearly 600 racially, ethnically, and socioeconomically diverse YMSM that began when the subjects were in their late teens and who are now in their early 20s. The study will also expand this cohort and recruit some 300 additional men who are also now in their early 20s.

The study will consider several factors that may explain the rise in incidence rates, ranging from the behavioral to the structural, including the social and sexual networks of YMSM, the role of homophobia and discrimination in society, and the presence of other sexually transmitted infections-as well as substance use and mental health burdens.

In addition, the researchers will consider the factors that explain both resilience and risk-why some acquire HIV while others do not and how does the development of sexual risk coincide with other health conditions. The goal, they explain, is to move away from a program of research focused solely on deficit models and to also consider how new biomedical technologies such as PrEP (pre exposure prophylaxis) affect HIV health in a new generation of men.

Armed with greater insights into the factors that lead to growing rates of HIV among this population, the researchers will seek to create ways to address it, in part, as informed by the effective strategies some young men are utilizing.

"Working with community and municipal partners, we will draw from what we have learned to develop strategies for HIV prevention and intervention that are relevant to this current and developing generation who did not live through the devastation of the AIDS epidemic in the 1980s," says Halkitis.

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